Although South Africa has moved on from the days of HIV denialism and advocating for beetroot to combat the disease while an HIV-positive boy named Nkosi Johnson pulled at heartstrings, the country still faces grim realities.
With a population of 57.73 million, of which just more than 7.52 million are infected with HIV, the country continues to have the highest infection rate.
Yesterday marked the 30th anniversary of World Aids Day, with the theme “Know Your Status”.
According to Statistics SA, the number of people living with HIV has increased from 4.25 million in 2002 to 7.52 million this year.
And although the country has the largest treatment programme in the world, with about 80% of the Aids response funded by the government, UNAIDS cites the country as accounting for 19% of people living with the disease in the world.
Even with this grim picture, strides have been made in the past 10 or so years in improving the quality of life for those living with HIV, including:
The issuing of antiretroviral drugs to patients as soon as they are diagnosed instead of waiting for their viral load to reach dangerous levels.
Increasing the availability of a range of medications that includes single dose pills, with few side effects.
The availability of home testing kits that can be found at pharmacies.
Life insurance for those living with the disease.
Health organisations say although the country has made great strides, not only in its attitude to the pandemic and the accessibility of treatment, more challenges continue to tip the scale in a unfavourable direction.
National chairperson of the Treatment Action Campaign Sibongile Tshabalala said: “As much as we are able to access treatment, we still have around seven million people who are HIV positive and we only have just over a half of those people, around four million, who are on treatment.
“At least the situation has changed from what it was before. We have people living longer, the denialism isn’t there either and when we talk about stigma and discrimination, it is no longer that prevalent.
“People are more accepting of those living with HIV and who are on treatment. We see more people who see the disease as another chronic illness.
“But, we still have challenges. The issue of stock-outs in facilities, where a person living with HIV will go to a clinic or hospital and not access treatment in a manner in which they are supposed to.
“Especially when it comes to the second-line regimen given to patients who are resistant to the first line of treatment, you find that in most facilities in provinces, there is no second-line regimen. And you find that patients are put on first-line regimens because there is nowhere else to find it.”
Tshabalala said the state of healthcare facilities was also of great concern.
“The issues we find plaguing a lot of our healthcare facilities is the maladministration and corruption, the lack of political will, where you find that services don’t reach the people they are meant for, and that has been the outcry to the minister to deal with corruption and increase human resources,” she added.
“And now, we are talking about the National Health Insurance, and the big question is: how can we implement it when we have all these problems we have? And when you look at our health facilities, they are in crisis.
“We are going to lose the battle against bringing down high infection rates because, as much as we have good policies in the country, implementing them is something else.
“The minister introduced the ‘test and treat’ campaign, as part of other preventative campaigns. You find that a person who is on treatment is able to keep their viral load low and chances of infecting others is low, but when we have situations like stock-outs, the opposite happens.”